Endoscopy system

ABSTRACT

An endoscopy system has an endo-robot that is navigable within an anatomical lumen of a patient by interacting with a magnetic field generated by an extracorporeal magnet system. The patient lies on a patient bed that is movable in one or more directions and/or orientations, and an obstacle detects objects in the movement path of the endo-robot in the anatomical lumen and produces a signal that causes the position and/or orientation of the patient bed to be altered dependent thereon.

BACKGROUND OF THE INVENTION

1. Field of the Invention

The invention concerns an endoscopy system.

2. Description of the Prior Art

In the implementation of methods in conventional endoscopy and incapsule endoscopy it may occur that, due to the position of the patient,intestinal loops lie in an intestinal section such that obstacles arisethat cannot be surmounted or can be surmounted only with greatdifficulty by the endoscope or by the endoscopy capsule. Among suchobstacles are, for example, kinks of the intestine, very narrow curvesor the compression of intestine portions caused by organs (for exampleother intestinal loops) pressing thereupon.

Furthermore, given a recumbent position of the patient an intestinesection can extend in the vertical direction. This position of theintestine section represents a “gravitational blockage” both for aconventional endoscope and for an endoscopy capsule since, in additionto the friction resistance of the endoscope or the endoscopy capsule inthe intestine, the weight of the endoscope or of the endoscopy capsulemust be overcome.

The aforementioned problems occur particularly in endoscopy withmagnetically navigable endoscopy capsules (endo-robots) wherein onlyslight forces are exerted on the endoscopy capsule by an externallygenerated magnetic field.

A system for endoscopic observation of the body is known from DE 4313843A1. This system has a coil device for generation of two homogeneousmagnetic fields standing at an angle to one another and an endoscopicmagnetic capsule on which a force is exerted due to the externalmagnetic fields. In order to enable locomotion of the endoscopic probein the body due to the homogeneous magnetic fields, a relative movementof body and probe is needed. The movement of the body is achieved by apatient bed that can be shifted in the height, length and transversedirections and can be displaced around its longitudinal axis. The magnetsystem itself can additionally be moved relative to the body. Themeasures described here are intended to obtain a force acting on theendoscopy probe and thus to achieve a linear locomotion.

An endoscopy system in which a magnetic endoscopy capsule can benavigated in a hollow organ of a patient is described in US2004/0181127. For this purpose, a magnetic field is generated by anexternal magnet system only at a point fixed relative to the magnetsystem. The movement of the endo-robot ensues exclusively viadisplacement and tilting of the patient bed. The navigation of theendo-robot is thus not always possible with the desired or requiredprecision.

An endo-robot (magnetically navigable endoscopy capsule) with whichminimally-invasive diagnoses and procedures can be implemented insidethe body of a patient is known via DE 101 42 253 C1. The endo-robot hasa bearing head in which measurement instruments and/or sample extractionand/or treatment instruments are integrated. The endo-robot furthermorehas a linear magnet that is arranged collinear with the longitudinalaxis of the endo-robot. The endo-robot is navigable via remote controlby a magnet system acquiring the examination region of the patient,which magnet system generates a 3D gradient field.

A wireless endoscopy apparatus in the form of a swallowable capsule isdisclosed in DE 103 17 368 B4, which capsule likewise has a permanentmagnet that is installed along an established longitudinal axis. Theendoscopy apparatus can be aligned from the outside via an externallyapplied magnetic field. The locomotion of the capsule through thedigestive tract ensues via the peristaltic movements of thestomach-intestine musculature. A dye stored in a dye reservoir can beintroduced in the tissue of the digestive tract via an outlet apertureconnected with the ink reservoir.

A device for examination of a contrast agent progression in the body ofa patient due to gravitation is known from DE 100 03 726 A1. The deviceincludes an MR scanner with a patient positioning system that enables anangled positioning of the patient.

The prior art devices rely on the assumption that locomotion (possiblysupported by a magnetic field) of an endoscopy capsule in the body ispossible without further measures. Problems of the aforementioned priorart (namely to react to obstacles, curves, incidental organ positions)are not addressed. No information is provided regarding how theseproblems would be solved (automatically, if possible).

SUMMARY OF THE INVENTION

An object of the present invention is to provide an endoscopy systemthat enables an improved and possibly automated locomotion of anendoscopy capsule, in particular in problematic zones, and thus exhibitsan improved precision in the navigation of the endo-robot.

The object is inventively achieved by an endoscopy system. Advantageousembodiments of the invention are the respective subject matter offurther claims.

The endoscopy system having an external magnet system and at least oneendo-robot as well as a patient positioning system, wherein at least oneendo-robot is navigable in a hollow human or animal organ by atemporally variable and spatially inhomogeneous magnetic field generatedby the external magnet system, and the patient positioning system has apatient bed that can be rotated around its longitudinal axis and/or canbe inclined in its longitudinal axis and/or can be displaced in at leastone spatial direction.

As used herein “endo-robot” means a magnetic endoscopy capsule (that isalso designated as a magnetic capsule endoscope).

An endo-robot can be navigated in a hollow human or animal organsignificantly more precisely by remote control not only by a magneticfield generated by the external magnet system at a point fixed relativeto the magnet system, but also by a temporally variable and spatiallyinhomogeneous magnetic field that is generated in a working volume bythe external magnet system such that a desired force and/or a desiredtorque acts on the endo-robot.

The working volume exhibits, for example, a diameter of 35 cm and alength of 20 cm. In order to be able to navigate the endo-robot from thestomach to the anus, the patient bed must be displaceable along itslongitudinal axis.

The endoscopy system according to the invention includes a detector fordetection obstacles to the movement of the endo-robot from which controlvariables for the position alteration of the patient positioning systemcan be derived in order, for example, to adjust the gravitational force(which acts both on organs or tissue parts and on the endo-capsuleitself) so as to contribute to the removal of hindrances to theendo-capsule or to support the movement respective to the movementdirection change of the endo-capsule. For example, by the rotation ofthe patient bed into a lateral position the patient is brought from hisrecumbent position into a lateral position. A horizontal movement istherewith achievable from a vertical movement of the endo-robot. Whenthe vertical movement direction contains a movement of theendoscopy-capsule from below to above, then a horizontal movement is nowpossible in a comparably better manner. A necessary horizontal movementcan be converted into a vertical movement from above to below byrotation of the patient bed.

Constrictions/contractions in the hollow organ due to other tissue partsor organs can also be remedied or at least minimized via the rotation orinclination adjustment of the patient bed, for example. Possibledisadvantageous positions of the hollow organ itself (for example kinks)can also be moderated. In all cases described in the preceding theexternal magnet system is thereby “unburdened”. The magnetic fields tobe generated can possibly be reduced or are henceforth sufficient at adetermined strength to realize a movement of the endo-capsule.

According to an advantageous embodiment of the inventive endoscopysystem, the magnetic system can be rotated around its longitudinal axisand/or can be inclined in its longitudinal axis and/or can be displacedin at least one spatial direction. The patient bed of the patientpositioning system and the external magnet system are therewithalternately displaced either alone (i.e. relative to the external magnetsystem) or together with this magnet system. In the latter case tiltingof the patient bed and magnet system on an axis transverse to itslongitudinal axis is also conceivable. Positions of the magnet systemrelative to the planned movement direction and/or the current positionof the endo-capsule (position of the magnet in the capsule) can likewisebe found in this manner, which positions ensure a maximum forceintroduction to the endo-capsule given simultaneous minimization of themagnetic field to be generated.

In an embodiment the endo-robot has a sensor device is provided fordetection of obstacles, the sensor device detecting at least onecounterforce that acts on it in the hollow organ. Such a sensor devicecould, for example, be based on one or advantageously a number ofperipheral pressure sensors. The data transmitted from these sensorsprovide indications or specifications (possibly via further interposedsoftware-supported evaluations) to the physician implementing theendoscopic examination) of how a manual displacement of the patient bedand/or of the magnet system should advantageously ensue.

In a further preferred development of the invention imaging methods areused as a means for detection of obstacles. Conclusions about obstaclesof any type likewise can be made using such imaging methods, andinstructions or specifications for displacement of patient bed and/ormagnet system can be provided to the physician in essentially asemi-automatic manner.

In a particularly preferred embodiment the patient bed and/or the magnetsystem can be automatically moved via the control variables such that anoptimal (i.e. as obstacle-free as possible) movement of the endo-robotthrough the lumen ensues and thus the power consumption of the magneticcoil system of the endo-robot is minimized and/or does not exceed apredeterminable maximum value. In this manner the treating physician canconcentrate on the procedure itself since an optimal support of themovement of the endo-robot is automatically taken care of.

According to a further embodiment the endoscopy system has a patient bedthat comprises at least in part a largely non-ferromagnetic material. Itis therewith ensured that the temporally variable and spatiallyinhomogeneous magnetic field generated by the external magnet system isnot adulterated.

In an advantageous manner the patient bed has at least in part amaterial with a low electrical conductivity. It is therewith reliablyavoided that eddy currents are induced, in particular given rapidchanges of the magnetic field.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 illustrates an external magnet system for generation of amagnetic field.

FIG. 2 is a side view of a patient bed of an embodiment of an endoscopysystem.

FIG. 3 is a cross-section through a patient bed of an embodiment of anendoscopy system.

DESCRIPTION OF THE PREFERRED EMBODIMENTS

In FIG. 1 a known (therefore not described in detail) magnetic coilsystem that is a component of an external magnet system is designatedwith 1.

The magnetic coil system 1 in the shown exemplary embodiment exhibits anapproximately cubical external contour and is, for example, a magneticcoil system of a magnetic resonance imaging apparatus. The corresponding6 cube surfaces are designated with F2 a, F2 b, F3 a, F3 b, F4 a and F4b. Per definition a right-angled (x,y,z) coordinate system is associatedwith the magnetic coil system, the origin of which coordinate systemlies in the center point of the magnetic system. The surfaces F3 a andF3 b lying orthogonal to the z-direction are thereby viewed as facingsurfaces, contrary to which the face pairs F2 a, F2 b or, respectively,F4 a, F4 b orthogonal to the x-axis and to the y-axis are considered aslateral face pairs. The face pairs enclose a distinct three-dimensionalinternal or working space A. The working space A of the magneticresonance apparatus 1 is surrounded by individual coils of the magneticcoil system.

A patient 2 to be examined lies on a patient bed of a patientpositioning system in the working space A. the patient positioningsystem with the patient bed is not shown in FIG. 1 for clarity. Acapsule-shaped endo-robot 3 is located in the hollow organ of thepatient.

The (rectangular or circular) cylindrical working volume (not shown)within which magnetic forces and/or torques can be exerted on theendo-robot 3 is located symmetrically around the center point of themagnetic coil system 1 within the working space A. The longitudinal axisof the cylindrical working volume coincides with the z-axis.

The working volume exhibits, for example, a diameter of 35 cm and alength of 20 cm. In order to be able to navigate the endo-robot from thestomach up to the anus, the patient bed must be displaceable along itslongitudinal axis.

For a navigation of the endo-robot 3 the magnetic resonance imagingapparatus coil system 1 comprises known means for detection of the realposition of the endo-robot 4 in the working space A. Such means are, forexample, the three position sensors 4 _(x), 4 _(y) and 4 _(z) with whichthe position of the endo-robot 3 is determined in the respectivecoordinate direction. The corresponding measurement values are suppliedto a regulation device 14. The magnetic resonance apparatus 1 serves asan obstacle detector that detects obstacles to the movement of theendo-robot and supplies a detector signal to the regulation device 14.Additionally, the endo-robot 3 itself may be provided with an obstacledetector 3 a, which also supplies a signal to the regulation device 14when an obstacle that impedes movement of the endo-robot through thebody lumen is detected.

An embodiment of a patient bed 5 that is inclined in its longitudinalaxis is shown in FIG. 2. The possible inclination via which the heightposition of the head and feet of the patient 2 can be varied relative tothe shown horizontal position is characterized by a double arrow 6, suchas by the operation of a stepper motor 16 supplied with an input fromthe regulation device 14.

The inclination in the exemplary embodiment shown in FIG. 2 is realizedvia support shims 7. However, in the framework of the invention otherpossibilities to achieve an inclination in the longitudinal axis of thepatient bed 5 are open to the average person skilled in the art.

In the embodiment shown in FIG. 3 a patient bed has a first supportingshell 8 that is borne in a second supporting shell afloat atop an aircushion. The supporting shell 8 that forms the actual patient bed cantherewith be rotated around its longitudinal axis and thus can becorrespondingly inclined.

In the shown exemplary embodiment the air cushion between the firstsupporting shell 8 and the second supporting shell 9 is generated inthat air (arrow 10) is introduced into a chamber 12 below the secondsupporting shell 9 via an air feed nozzle 11. the air from the chamber12 arrives between the two supporting shells 8 and 9 via a number of airpassage openings 13 in the second bearing shell 9. The supporting shell8 carrying the patient 2 can therewith be rotated (and therewith panned)around its longitudinal axis nearly without friction.

The measures realized in the patient bed 5 and the supporting shell 8can also be combined with one another.

In order to avoid a position change of the patient 2, at least onepatient retention device 15 is provided.

Although modifications and changes may be suggested by those skilled inthe art, it is the intention of the inventors to embody within thepatent warranted heron all changes and modifications as reasonably andproperly come within the scope of their contribution to the art.

We claim as our invention:
 1. An endoscopy system comprising: anendo-robot configured for in vivo navigation in an anatomical lumen of apatient; an extracorporeal magnet system that generates a temporallyvariable and spatially non-homogenous magnetic field that interacts withthe endo-robot to move said endo-robot in said anatomical lumen; apatient positioning system comprising a patient bed configured toreceive the patient thereon while said endo-robot is in said anatomicallumen, said patient bed having a longitudinal axis and being operable toexecute at least one movement, and comprising a first supporting shell,and wherein said patient bed comprises a second supporting shell withsaid first supporting shell being supported by an air cushion in saidsecond supporting shell and tilting on said air cushion relative to saidsecond supporting shell, as said at least one movement; an obstacledetector that detects obstacles to the movement of the endo-robot in theanatomical lumen, said obstacle detector generating a detector signalupon said endo-robot encountering an obstacle to the movement of theendo-robot in the anatomical lumen; and a control unit configured toautomatically operate said extracorporeal magnetic system and saidpatient positioning system, and being automatically supplied with saiddetector signal, said control unit being configured, upon said detectorsignal indicating that said endo-robot has encountered an obstacle, toautomatically cause said patient positioning system to execute said atleast one movement to assist said endo-robot in overcoming said obstacleand to avoid said magnetic field generated by said extracorporeal magnetsystem from having to move the endo-robot, by virtue of the magneticfield itself, to overcome said obstacle.
 2. An endoscopy system asclaimed in claim 1 comprising at least one stepper motor in mechanicalengagement with said patient bed, and wherein said control unit isconfigured to operate said stepper motor to drive said patient bed toexecute said at least one movement.
 3. An endoscopy system as claimed inclaim 1 wherein said magnet system has a magnet system longitudinal axisand is operable to execute at least one movement selected from the groupconsisting of rotation around said magnitude system longitudinal axis,inclination relative to said magnet system longitudinal axis, anddisplacement in at least one spatial direction.
 4. An endoscopy systemas claimed in claim 1 wherein said obstacle detector comprises a sensoron said endo-robot that detects a counter force acting on saidendo-robot in said anatomical lumen counter to said movement of saidendo-robot.
 5. An endoscopy system as claimed in claim 1 wherein saidobstacle detector comprises an imaging system that produces, as saiddetector signal, an image of said obstacle.
 6. An endoscopy system asclaimed in claim 1 wherein said control unit is configured to derive anendo-robot position measurement from said detector signal that isindicative of a direction of movement of the endo-robot.
 7. An endoscopysystem as claimed in claim 1 wherein said control unit is configured toautomatically control at least one of said magnet system and saidpatient bed to cause power consumed by said magnetic coil to beminimized or not to exceed a predetermined value.
 8. An endoscopy systemas claimed in claim 1 wherein said patient bed is formed substantiallycompletely of non-ferromagnetic material.
 9. An endoscopy system asclaimed in claim 1 wherein said patient bed is comprised substantiallycompletely of a material having a low electrical conductivity.
 10. Anendoscopy system as claimed in claim 1 wherein said patient bedcomprises at least one patient retention device.
 11. An endoscopy systemas claimed in claim 1 comprising a closed magnetic resonance scanner andwherein said extracorporeal magnet system is a magnet system of saidclosed magnetic resonance scanner.
 12. An endoscopy system as claimed inclaim 1 comprising a closed magnetic resonance scanner and wherein saidextracorporeal magnet system is a magnet system of said open magneticresonance scanner.